First Non-Imported Case Of Crimean-Congo Haemorrhagic Fever Hits Europe

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The 62-year-old man, who died on 25 August in Madrid’s Gregorio Marañón hospital, is thought to have contracted the fever after being bitten by a tick while walking in the countryside in the Castilla-Léon region of Spain. (source)

Like Ebola and other haemorrhagic viruses Crimean-Congo Haemorrhagic Fever can be passed from person to person through direct contact with their blood or body fluids, therefore there is no risk to the general public providing the person and their associates are isolated until they are shown to be free of the disease.

Health authorities in Madrid are taking steps to contain the outbreak that so far has killed one and infected the nurse that initially treated the man. Over 200 contacts of the patient and the nurse are being monitored for signs of the disease.

CCHF is endemic (widespread and constantly there) in many parts of the world including Africa, parts of Asia, the Middle East and the Balkans region. It’s caused by a bite from an infected tick that carries the virus. All cases in Europe and the UK so far recorded have been found in returning travellers, this is the first recorded case of a tick bite in Western Europe causing the disease…and where there is one tick, there are more ticks.

The World Health Organisation states that the disease has a fatality rate of 10-40%.

Crimean-Congo haemorrhagic fever (CCHF) is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10–40%.

Domestic cattle, sheep, goats, a variety of wild animals and some birds are reservoirs for the disease. Until the Spanish case earlier this month the geographical spread of the ticks that act as a vector for CCHF was not known anywhere in Europe except the far eastern balkan states.

CCHF spreads in exactly the same way as mosquitoes spread malaria. An infected tick bites a person or animal and the virus is passed on through the bite. Subsequent ticks biting an infected animal or human then carry the virus to the next animal or human they bite. The virus stays live and transmissible for 7 days after infection.

Direct contact with the blood, faeces or bodily fluids of infected animals or humans can spread the disease, this includes the re-use of needles and syringes and incorrect sterilisation of surgical instruments. Many cases occur in slaughterhouse workers, workers in the livestock industry and vets in areas where CCHF is endemic.

The arrival of the ticks that spread CCHF (ticks of the genus Hyalomma) was inevitable at some point. The worry is what to do about it. Like all the other haemorrhage viruses there is no cure except rehydration therapy and palliative care though The antiviral drug Ribavirin has been used to treat some cases but studies are still ongoing to assess it’s effectiveness.

Control of the ticks that cause the disease is one of the few ways that CCHF can be kept under control. Like Ebola it has the potential to cause epidemics with a high mortality rate. The news that such a disease has found it’s way to Western Europe is alarming to say the least.

Take care

Liz

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